FidoPharm announced recently that it's launching a new generic canine heartworm product called PetTrust. The chewable preventive
It is obvious to me, after having practiced for almost 37 years, that we are going to lose our pharmacies as a profit center. I think it is ironic that these companies that are going around traditional veterinary channels say they are doing so because the veterinary community is, in so many words, not doing their job in meeting pet owner's demands. Sure, just like the reason there are so many stray and unwanted pets is because there are not enough spay or neuter clinics. These companies come across like they have pet's and pet owner's best interests at heart, when in actuality the net effect is going to be higher veterinary fees so we can keep our doors open. Organized veterinary medicine is, at some point, going to have to stand up to the unfair tax-exempt/subsidized clinics that have an unfair economic adavantage over private practitioners or some private clinics are going to end up closing or at least laying off people. This "chipping away" at the profession is not a good thing for the consumer in the long run. Also, if we lose our pharmacies what incentives will animal pharmaceutical companies have for developing new products, as veterinarians will no longer have any incentive to market them to their clients to improve the pet's quality of life.
Edited by drjjj, 2 years ago
Well... new office call price $95.00, Heartworm test $65.00 total $160.00 yep it's easy to see how this new product is going to encourage office visits and increased compliance
Is Walmart ever going to get enough. They are grasping greedy people. What is next, dental office, medical practice inside the front door. They are not getting in to pet meds to help people, but to help themselves
Here's some interesting info for y'all:
1 - I called and spoke w/ a rep from Fido Pharm about their product and was told they do NOT have a guarantee that if the pet is on yr round and they get HW's that they will cover the cost of treatment. I was told they are "working on it."
2 - According to the info Walmart so kindly faxed to our clinic, PetTrust is not A/B rated, so (at least by Nebraska law) it is not directly substitutable for Heartgard. If I was reading the FDA website correctly, this lack of rating means that it is not a bioevquivalent to Heartgard. "A generic drug is considered bioequivalent to a brand-name drug if it contains the same active pharmaceutical ingredient as the branded drug, AND if the there is no significant difference in the formulation, quality and effectiveness of the two drugs." (www.takerx.com) I am waiting on a response from the FDA's veterinary end to see if the same bioequivalence ratings apply to meds for animals.
Just some food for thought.
Really? We sort of did away with ours back in 2007. It never was a significant revenue generator in the first place. We carry only the things you can't get at a local pharmacy (although that is completely changed now anyway), such as Rimadyl and Baytril. Yes indeed, it is sometimes more expensive to the client outside the clinic than in-clinic, but the clients want the flexiblity and convenience to shop and make their own decisions, and who are we to get in the way of that?
When your practice is sandwhiched between a PetCo, WalMart, CVS, and WalGreens, you learn very quickly you can't compete on drug pricing.
Unfortunately, now the Target which is a short hop, skip, jump away from us is going to open their PetRx and carry veterinary formulated drugs like Rimadyl and Baytril, we don't even need to carry those. And I personally like the Target pharmacy in our area (I used to work for the store itself actually, awhile ago), and I use it for our family pharmacy. Heck, I love their patient identification system, and they are the only pharmacy I've never had difficulty with in regards to having twins. As a veterinary professional, that's pretty sad to say that I'd rather use the Target pharmacy than an in-house one, and if I had the money, sure as heck love to model an in-house pharmacy after the Target pharmacy.
So, we've had to change our treatment protocols. Where it is medically appropriate, we provide an in-clinic injection of what we'd normally dispense. If we were going to dispense Rimadyl, now the pet in the office gets an injection of Rimadyl, and a written script for the oral meds to take to the pharmacy of their choice. We inform the owner how long the efficacy of the injection is, so that gives them some lag time to get the script filled. And, the client can return for injections (follow-up exams), as many times as necessary until they can get the script filled.
No, we're not practicing "steroid" medicine (except where indicated). Owners want us to "fix" their pets, and want that "fix" to be "quick." An injection of the approriate medication in-house does that for them.
It has increased our average transaction fee this way, and clients are a bit more receptive because they see us "doing something" that provides near immediate relief for their pet.
I'm glad we don't need to carry the burden of pharmacy overhead anymore, it is expensive to do. For convenience we are connected to a 3-rd party online pharmacy for our clients, but with that generating only a 20% profit margin, hey, I figure something is better than nothing.
So, medication manufacturers could very well be motivated still to provide quality veterinary products in the injectable catagory...medications that can only be administered at a veterinary hospital. That's what we could lobby for.
Generic ratings by the FDA only apply to human medicines, not veterinary medicines: http://www.fda.gov/AnimalVeterinary/GuidanceComplianceEnforcement/ComplianceEnforcement/UnapprovedAnimalDrugs/ucm249392.htm
The only reason the A/B rating was mentioned is because it is being sold through a human pharmacy.
PetTrust can be found in the FDA's listing of FDA approved drugs: http://www.accessdata.fda.gov/scripts/animaldrugsatfda/
BUT they still do not stand behind their product with any sort of guarantee, this I got straight from the PetTrust rep.
Edited by jamiekavan, 2 years ago
One solution not really being mentioned is to add a "real" pharmacy to the veterinary clinic. My physician's office has had a pharmacy across the hall for over 25 years. For the start, since veterinary drugs requrie "order or supervision of a veterinarian" wouldn't need a licensed pharmacist if doing in house...build a small cubicle with 2 windows accessing the waiting room....one for drop off scripts and one for pickup....let the owner come out of the exam room to the reception desk and give them the option of filling it there and only writing one check or one swipe of the card or going to another pharmacy for filling. They take the script to the drop off window...tech(s) go to pharmacy area, fill as normal and bring up to the pick up window.....of course all these extra steps and potential loss of revenue means higher fees but it makes everybody happy, right? Of course not, but have to go with the times. My GP charges $95.00 a visit, a specialist gets around $300.00 a visit...why are we only getting somewhere around 30?????? Let's just bite the bullet, go whole hog and promote insurance until the paperwork drives everyone to distraction, charge 5x what we have been and see if we can't get some of the Medicare/Medicaid pie too....we know having a pet helps the sick emotionally.....I've written many scripts over the last 28 years...I don't have a problem and it helped keep my inventory costs low when I owned a practice.
My clinic is in a rural community, population <15,000. My clinic does not have a huge pharmacy and we do have an on-line pharmacy through vets first choice to help our out of town clients and those that work past our office hours. I do on occassion use a human pharmacy for medications that I do not carry or provide on our on-line pharmacy. In most cases, we just call them in to Walmart and other local pharmacies. We work hard to stay competitive with local and other on-line pharmacies. My pharmacy is not the financial epi-center for my clinic. For the most part, the pharmacy is more of a convenience to my client. However, there is no denying that the pharmacy does contribute to our gross income. A good many don't want to make two stops with their dog/cat left in the car while they wait for 30 minutes for Walmart to fill their pet's script. In most cases, the pet owner wants the pet to get better asap and filling the meds in the clinic is the quickest way to make that happen. We usually pill the critter with their first medication, so that we can demonstrate how to pill and get the pet started on it's road to recovery. Most owners really appreciate this.
I actually have two problems with human pharmacies and on-line pharmacies filling my prescriptions. First of all, companies such as Pet Meds advertise they are 'cheaper than their veterinarian', when in fact this is not necessarily the case, at least not in my clinic. In most cases, we are cheaper than Pet Meds. Secondly, their phrasing of 'cheaper than your vet' has an underlying implication that the client's veterinarian is just out to scalp the client's pocket book, after all we all know the only reason we practice medicine is to get rich! The client has not necessarily interupted the phrase as it is Pet Meds is the one out to get their money and could care less about the pet.
Secondly, I am very concerned about the tracking of these medications, especially those medications such as heartworm prevention and for other serious health medications. It's one thing to leave a script for an antibiotic for an abscess, but totally different for medications such as heartworm prevention. My office tracks continual medications and when the medication is due for refilling we send reminders to the owner. If the owner tells us that they still have plenty, we know they have not been giving it properly and can educate them about the importance of proper dosing. Is Walmart going to do this? We have several clients that share heartworm medication with between same size dogs; a six month supply last 3 months for 2 dogs and need more frequent refills. They do this because of economics, they cannot afford a six month supply for each dog. They prefer refilling every 3 months. If I outsource heartworm prevention, I will insist on scripting for each dog. They will not fill at the same time and again, the tracking get's lost at Walmart. If this owner does not refill promptly and keep the dog on prevention is Walmart going to contact the owner in anyway about the dangers? are they going to contact the veterinarian that the dog has not been on prevention? My alternative is to require a heartworm test every year, which we do anyways, but get plenty of declines and waivers signed about prevention without testing. So my paperwork increases and likely, fewer dogs will be tested and on prevention. I ask myself is this better medicine?
Since human pharmacists are not educated in animal medicine, is their computer database armed for print outs on potential side effects of drug, how to give and when should they re-check with their veterinarian? When my clients come to me for this information, since they do not get it from the human pharmacy, and I charge a nominal fee for pharmacy consult and medical record review, I risk offending my client for the additional fee (and believe me they will be upset with it), how do I explain that to my client?
As others have commented, with the loss of even the slightest amount of revenue from drugs, somewhere we have to compensate to cover our overhead, so our office calls go up, lab work goes up, etc. I wonder how many clients will be lost just because they cannot afford an average transaction fee of $150 vs our current $65.00.
In all, this is something we have to face, no doubt. But the expense and work of it will be passed on to us, the client and certainly not Walmart of Pet Meds.